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Case report
Ectopia cordis: a novel palliative care technique
  1. Mary Judith Berry1,2,
  2. Maria Saito-Benz2,
  3. Tisha Klein2,
  4. Brendon Bowkett2 and
  5. Vaughan F Richardson2
  1. 1Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
  2. 2Neonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand
  1. Correspondence to Dr Mary Judith Berry, Department of Paediatrics, Wellington Hospital, Private Bag 7902, Wellington South, New Zealand; max.berry{at}otago.ac.nz

Abstract

Complete ectopia cordis in the newborn represents a significant management challenge. There are minimal data available to inform optimal clinical care for those infants with coexisting complex congenital heart disease who are therefore not candidates for surgical intervention. The exteriorisation of the heart and absence of the pericardial sac requires meticulous wound care to prevent desiccation of the myocardium and to minimise infection risk. Additionally, the technique selected must address the risk of occlusion of the cardiac vascular pedicle and abrasion between the mobile myocardium and dressing surface. We report a novel approach to wound management and integrated palliative care that enabled community-based care. Our patient, a full-term male infant with complete ectopia cordis was born in good condition by assisted vaginal delivery. He was discharged from hospital on day 8 and was cared for in the community until his demise from cardiac failure on day 15.

  • Congenital cardiac anomaly
  • Ectopia cordis
  • Neonatal palliative care

https://doi.org/10.1136/bmjspcare-2015-000946

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    Footnotes

    • Contributors MJB was the lead clinician for the patient, she developed the patient care plan and cowrote the manuscript. MS-B cowrote and submitted the manuscript. TK was the lead palliative care nurse and revised the manuscript. BB was the paediatric surgeon and codeveloped the cardiac dressing. VFR was the NICU clinical director, and oversaw all aspects of the patient care and assisted with manuscript revision.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.